Citation Nr: 1014895
Decision Date: 04/20/10 Archive Date: 04/30/10
DOCKET NO. 06-06 620 ) DATE
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On appeal from the
Department of Veterans Affairs Regional Office in St.
Petersburg, Florida
THE ISSUE
Entitlement to service connection for posttraumatic stress
disorder (PTSD).
REPRESENTATION
Appellant represented by: The American Legion
ATTORNEY FOR THE BOARD
S. Flot, Associate Counsel
INTRODUCTION
The Veteran served on active duty from December 1963 to
December 1967.
This matter comes before the Board of Veterans' Appeals
(Board) on appeal from a December 2004 rating decision from
the Department of Veterans Affairs (VA) Regional Office (RO)
in St. Petersburg, Florida.
The appeal is REMANDED to the RO via the Appeals Management
Center (AMC), in Washington, DC. VA will notify the
appellant if further action is required.
REMAND
For the reasons set forth below, the Veteran's claim of
entitlement to service connection for PTSD must be remanded.
Although the Board sincerely regrets the additional delay, a
remand is necessary to ensure that there is a complete record
upon which to decide the Veteran's claim so that he is
afforded every possible consideration.
A review of the claims file reveals that to date, VA has
neither afforded the Veteran a medical examination nor
solicited a medical opinion regarding his claim. The Board
finds that both a medical examination and medical opinion are
necessary in this case for two reasons.
First, VA treatment records indicate that the Veteran has
been diagnosed with anxiety, PTSD, and chronic PTSD. It is
unclear, however, whether the diagnoses of PTSD and chronic
PTSD comply with the Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV) (4th ed. 1994). See 38 C.F.R.
§ 4.125 (providing that a diagnosis of a mental disorder must
conform with the criteria set forth in the DSM-IV); see also
Cohen v. Brown, 10 Vet. App. 128, 140 (1997). A medical
examination and opinion therefore are necessary to
substantiate the Veteran's diagnosis.
Second, VA must provide a medical examination or obtain a
medical opinion when there is: (1) competent evidence that
the Veteran has a current disability or persistent or
recurrent symptoms of a disability; (2) evidence establishing
that he suffered an event, injury or disease in service or
manifested certain diseases during an applicable presumption
period; (3) an indication that the current disability or
symptoms "may" be associated with service or with another
service-connected disability; and (4) insufficient competent
medical evidence of record to make a decision on the claim.
38 U.S.C.A. § 5103A(d); 38 C.F.R. § 3.159(c)(4); see also
Wells v. Principi, 326 F.3d 1381 (Fed. Cir. 2003); McLendon
v. Nicholson, 20 Vet. App. 79 (2006).
The Veteran asserts that several incidents during his service
in Vietnam are stressors that caused his psychiatric
problems. VA treatment records reveal that the Veteran
discussed some of these incidents in conjunction with his
psychiatric treatment. However, these records neither affirm
nor disaffirm the existence of a link between any of the
Veteran's claimed in-service stressors and his psychiatric
difficulties. The Board therefore has evidence of a
potential nexus between the Veteran's psychiatric problems
and his service but does not have sufficient competent
medical evidence to render a decision on his claim. As such,
a remand is necessary to arrange for the Veteran to undergo a
medical examination and for an opinion to be rendered
regarding whether any psychiatric disorder diagnosed pursuant
to the DSM-IV is related to the Veteran's claimed in-service
stressors.
Accordingly, the case is REMANDED for the following action:
1. Review the Veteran's claims file
and undertake any additional
development indicated. This may
include obtaining and associating with
the claims file any additional
pertinent records identified by the
Veteran during the course of the
remand. It also may include, if
necessary, undertaking additional
development regarding the Veteran's
claimed in-service stressors.
2. After completion of the above
development, arrange for the Veteran to
undergo an appropriate VA examination
to determine the location, nature,
extent, onset, and etiology of any
psychiatric disorder, to include PTSD,
found to be present. The claims file
shall be made available to and reviewed
by the examiner, and the examiner shall
note such review in an examination
report. All indicated studies deemed
necessary shall be performed, and all
findings shall be reported in detail.
The examiner shall comment on the
Veteran's reports regarding the onset
and continuity of his psychiatric
symptoms and describe the evidence of
all such symptomatology. If a
psychiatric disorder consistent with
the DSM-IV is diagnosed, the examiner
shall opine as to whether it is at
least as likely as not (a 50 percent or
greater probability) that the disorder
is related to service, particularly to
one or more of the Veteran's claimed
in-service stressors, or had its onset
during service. The rationale for all
opinions expressed shall be provided in
a legible report.
3. Thereafter, readjudicate the
Veteran's claim. If the benefit sought
on appeal is not granted, the Veteran
and his representative shall be
provided with a supplemental statement
of the case and afforded a reasonable
opportunity to respond.
The appellant has the right to submit additional evidence and
argument on the matter the Board has remanded. Kutscherousky
v. West, 12 Vet. App. 369 (1999).
This claim must be afforded expeditious treatment. The law
requires that all claims that are remanded by the Board of
Veterans' Appeals or by the United States Court of Appeals
for Veterans Claims for additional development or other
appropriate
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action must be handled in an expeditious manner. See 38
U.S.C.A. §§ 5109B, 7112 (West Supp. 2009).
_________________________________________________
JONATHAN B. KRAMER
Veterans Law Judge, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Appeals for Veterans Claims. This remand is in the
nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal.
38 C.F.R. § 20.1100(b) (2009).